Provider Demographics
NPI:1831562024
Name:EARNSHAW, VICKI L (RDH)
Entity type:Individual
Prefix:MS
First Name:VICKI
Middle Name:L
Last Name:EARNSHAW
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:MS
Other - First Name:VICKI
Other - Middle Name:L
Other - Last Name:JACOBS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7940 S. UNIVERSITY BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80122
Mailing Address - Country:US
Mailing Address - Phone:720-482-0793
Mailing Address - Fax:720-482-0796
Practice Address - Street 1:7940 S. UNIVERSITY BLVD.
Practice Address - Street 2:SUITE 200
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80122
Practice Address - Country:US
Practice Address - Phone:720-482-0793
Practice Address - Fax:720-482-0796
Is Sole Proprietor?:No
Enumeration Date:2015-11-10
Last Update Date:2015-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO903787124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist